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Updated: Sep 2, 2025

Author Spotlight: Advancements in Molecular Biomarker Testing for Non-Squamous Non-Small Cell Lung Cancer
Published on: September 8, 2023
Impact of the COVID-19 pandemic on non-small-cell lung cancer pathologic stage and presentation
Joshua A J Keogh1, Allison D Chhor1, Housne Begum1
1From the Department of Kinesiology, McMaster University, Hamilton, Ont. (Keogh); the Division of Thoracic Surgery, St. Joseph's Healthcare, Hamilton, Ont. (Keogh, Begum, Finley); the Faculty of Health Sciences, McMaster University, Hamilton, Ont. (Chhor); and the School of Nursing, McMaster University, Hamilton, Ont. (Akhtar-Danesh).
Background:
It is believed that the cessation of normative cancer care services during the COVID-19 pandemic may be resulting in pathologic upstaging and higher long-term mortality rates. We aimed to understand how the pandemic has affected our patients diagnosed with non-small-cell lung cancer (NSCLC).
Methods:
We conducted a single-centre retrospective analysis to assess how the COVID-19 pandemic has affected patient referrals, pathologic stage of NSCLC, mortality rates and surgical procedures at our cancer care centre in Ontario, Canada. At our centre, physicians advocated for and followed recommendations that operations in cancer patients should be among the last procedures to be delayed. Patients were included if they were aged 18 years or older, were not receiving palliative care, and had been screened, diagnosed and treated for NSCLC (primary tumours). We compared outcomes between a prepandemic period (January 2019 to February 2020) and a period during the pandemic (March 2020 to February 2021).
Results:
A total of 695 patients were included for statistical analysis, of whom 650 underwent surgery. There was no statistically significant difference in any of the outcomes of interest between patients seen before (n = 330) and during (n = 320) the pandemic.
Conclusion:
Cancer care services at our centre were maintained during the COVID-19 pandemic, and potential adverse effects on prognosis and survival that have been seen in other countries were avoided. The results inform health care providers how the effects of future pandemics can be blunted by using proactive preservative strategies and surgeon advocacy.
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